russ_watters said:
Have you considered the vast differences in technology and available care? For example, cancer care is expensive, right? Well chemotherapy was invented in 1965. Before that, there wasn't much in the way of treatment.
The use of technology make things expensive: MRI, CT scan, etc. Drugs themselves become more sophisticated and expensive to discover/invent.
Healthcare costs rise in large part because healthcare itself advances.
True. There's also somewhat of a hard question regarding this.
Aren't expensive scans a particularly hard call? One doesn't really know for sure whether they need to do the scan until after they've done it. Sometimes they might estimate only a 1% chance of anything that might be detected by the scan, but they don't want to take chance so they order the scan.
If the patient is insured, then there's no real question; order the scan and get paid! If the person is really poor, maybe they order the scan, and report the cost as charity. If the person is uninsured, they tell the patient, there's only a 1% chance of this scan picking up anything; and ask if he wants to pay an extra $5000 to get the scan done?
Or if they're worried about malpractice, they order that scan for everybody, regardless of the cost, because the cost of malpractice lawsuits from that 1% of the people that actually do have the problem that could have been detected by the scan is just too great.
In any case, the hospital may make a cost-benefit analysis of whether to do the scan, or they may have a policy of "We're Going To Do Everything We Can For Anybody That Comes In" which means, YES, they're going to do that scan, and YES, they're going to get that $5000, at least 10% of the time. (Maybe it would have only cost $500 if they got it all the time.)
I don't know if there is really any right-or-wrong answer to the question of end-of-life care. There are some people who will just say, "Just let me die. I've had a good life." And others that will say "Do everything you can to keep me alive." And some people that are not rational enough to make such decisions. (That's what living wills are for).
The medical bills from the last couple of years of a persons life can be the highest cost bills of all their life. Are there really tough decisions to be made here? Depending on the way you look at it, yes or no. "Yes," we need to consider the quality of life, and whether it is worth the money to live for a few more days or weeks. Or "No." No cost is too great, we must do everything we can to keep the person alive.
But I think the main difference between the Republicans and Democrats is whether we handle it on the demand-side or the supply-side.
The Democrats are appalled at the current system, where people who can't afford health care simply go without. They can come to the emergency room if they have a major problem, but as far as preventative care, and regular check-ups, they do not have access to this. They are interested in creating an environment where a certain minimal level of health care is available to everyone, regardless of economic status.
The Republicans appear to be appalled by the idea that some government "Death Panel" will be rationing the health-care, making the choices of under what circumstances procedures are allowed and disallowed, and will somehow prevent them from having the best health-care that money can buy.
I should also say how the Democrats "appear to be" because the two last paragraphs are not quite parallel. The Democrats "appear to be" wanting the most expensive possible health-care for everyone regardless of economic status. I don't think that's really what they want. They just want to have access to a Doctor (or a nurse, or a clinic) without it
having to be an emergency life-or-death situation. And, emergency or not, we'd like to be able to walk into the doctor (or be wheeled in on a stretcher) without the fear that we will financially ruined when we come out.